Unique liver function in high myopia: associations with myopic macular degeneration.

PURPOSE: To investigate liver function and lipid indexes in patients with high myopia and their association with myopic macular degeneration (MMD). METHODS: This cross-sectional comparative study included 995 emmetropic patients and 805 highly myopic patients. Serum levels of liver function and lipid indexes were measured using a Roche C702 biochemical analyzer. Ultra-widefield fundus photographs of eyes were classified according to the International META-PM Classification: Category 0: No myopic retinal degeneration, Category 1: tessellated fundus, Category 2: diffuse choroidal retinal atrophy, Category 3: patchy choroidal retinal atrophy, Category 4: macular atrophy. A machine learning model based on liver function indexes was employed to predict the presence of MMD in patients with high myopia. RESULTS: Serum levels of albumin (Alb), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT) and triglyceride (TG) were significantly lower, whereas high-density lipoprotein cholesterol (HDL) and apolipoprotein-A (Apo-A) were higher in patients with high myopia than those in emmetropic patients (all P < 0.05). Significant differences in serum ALT and GGT were found among MMD categories (both P < 0.05). Multivariate logistic regression showed that MMD4 was associated with lower serum GGT than MMD1 (P < 0.05). The decision tree model to predict MMD achieved an area under the curve (AUC) of 0.735 using serum GGT (sensitivity = 53.12%; specificity = 82.09%; P < 0.001). When using multiple liver function indexes, the AUC of the model reached 0.803 (sensitivity = 73.4%; specificity = 76.1%; P < 0.001). CONCLUSION: We identified close associations between liver function and MMD, suggesting serum GGT serve as a potential diagnostic indicator for MMD among highly myopic patients.